Active NPI
Stephen Robert Young, P.T.
- Physical Therapist
- Breckenridge, MN
National Provider Identifier
1982883401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2054
- Practice address
- 2400 St Francis Dr
Breckenridge, MN 56520-1025 - Phone
- (218) 683-0350
- NPI assigned
- Oct 31, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2054 | MN | Primary |
| Physical Therapist | 225100000X | 0411 | ND |
Addresses
Primary practice location
2400 St Francis Dr
Breckenridge, MN 56520-1025
Mailing address
2400 St Francis Dr
Breckenridge, MN 56520-1025
Phone (218) 683-0350
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0411 | ND | MD | Physical Therapist |
| 2054 | MN | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193788800000",
"number": "1982883401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 ST FRANCIS DR",
"city": "BRECKENRIDGE",
"state": "MN",
"postal_code": "565201025",
"telephone_number": "218-683-0350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 ST FRANCIS DR",
"city": "BRECKENRIDGE",
"state": "MN",
"postal_code": "565201025",
"telephone_number": "218-683-0350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "STEPHEN",
"middle_name": "ROBERT",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-31",
"last_updated": "2007-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "2054",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ND",
"license": "0411",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Breckenridge, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.